R. Manfredi et al., Pancreas divisum and "santorinicele": Diagnosis with dynamic MR cholangiopancreatography with secretin stimulation, RADIOLOGY, 217(2), 2000, pp. 403-408
Citations number
21
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To evaluate the usefulness of magnetic resonance(MR) cholangiopanc
reatography (MRCP) before and after secretin administration in diagnosing s
antorinicele in patients with pancreas divisum.
MATERIALS AND METHODS: One hundred seven patients suspected of having pancr
eatic disease underwent MRCP before and after secretin administration (S-MR
CP). S-MRCP images were evaluated for pancreas divisum and santorinicele an
d for size of the main pancreatic duct and santorinicele. The onset of duod
enal filling was calculated on dynamic S-MRCP images.
RESULTS: Pancreas divisum was detected in five (5%)of 107 patients at MRCP
and in 10 (9%) of 107 patients at S-MRCP. Santorinicele was detected in thr
ee (21%) of 14 patients at MRCP and in an additional four (seven [50%] of 1
4) patients at S-MRCP in patients with pancreas divisum. Santorinicele was
confirmed in six of seven patients at endoscopic retrograde cholangiopancre
atography (ERCP); in one of seven patients, ERCP was unsuccessful. The duct
of Santorini was significantly (P < .05) larger in the pancreatic head in
patients with pancreas divisum and santorinicele (3.6 mm) compared with tho
se with only pancreas divisum (2.2 mm). A noteworthy reduction in size of t
he pancreatic duct (26%) and of the santorinicele (63%) was observed after
sphincterotomy. The onset of duodenal filling was delayed significantly in
patients with santorinicele (2.1 vs 1.3 minutes; P < .05).
CONCLUSION: S-MRCP helps in identifying pancreas divisum and santorinicele,
which may be the cause of impeded pancreatic outflow.